ANTI-MULLERIAN HORMONE IN POLYCYSTIC OVARY SYNDROME: DIAGNOSTIC VALUE AND LIMITATIONS

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in reproductive-age women and is characterized by a combination of ovulatory dysfunction, hyperandrogenism and polycystic ovarian morphology. Anti-Müllerian hormone (AMH), produced by granulosa cells of preantral and small antral follicles, is considered a promising biomarker for assessing polycystic ovarian morphology and supporting the diagnosis of PCOS. According to the 2023 international evidence-based guideline, AMH can be used instead of ultrasound to define polycystic ovarian morphology in adult women within the diagnostic algorithm; however, it should not be used as a single diagnostic test for PCOS. Recent systematic reviews and meta-analyses demonstrate relatively high diagnostic accuracy of AMH, while also showing substantial heterogeneity between studies. AMH concentrations and their diagnostic interpretation may be influenced by age, body mass index, PCOS phenotype, hormonal contraception and assay methodology. Therefore, the clinical use of AMH requires standardization and interpretation within the individual clinical context. The aim of this thesis is to evaluate the diagnostic value of AMH in PCOS and to consider the major limitations of its use as a biomarker of the disease.